Provider Demographics
NPI:1598045882
Name:RENTSCHLER, AMANDA M (DMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:RENTSCHLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2425
Mailing Address - Country:US
Mailing Address - Phone:360-424-5650
Mailing Address - Fax:360-424-9672
Practice Address - Street 1:1210 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2425
Practice Address - Country:US
Practice Address - Phone:360-424-5650
Practice Address - Fax:360-424-9672
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60395108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist